Risk Factors for Community-acquired Pneumonia among Children Under-five Years in Asia: A Systematic Review of Observational Studies
DOI:
https://doi.org/10.55175/cdk.v50i9.841Keywords:
Community-acquired pneumonia, childhood pneumonia, risk factor, AsiaAbstract
Background: Pneumonia is the leading cause of death among less than 5 year-old children worldwide, mainly in Asia in the form of community-acquired pneumonia. As primary prevention is considered crucial in combating the disease, risk factors need to be analyzed. Methods: Based on the PRISMA guidelines, observational studies were explored systematically by the PubMed MEDLINE database with inclusion and exclusion criteria. The studies retrieved are then assessed with the STROBE method. Results and Discussion: A total of 8 studies were included, with total participants of 16.862 children. STROBE score results range from 12.2 to 19.6. Several risk factors were associated with pneumonia and risk factor; the highest odds ratio are daytime abnormal behavior (OR: 11.06, 95% CI: 1.51-81.26, p=0.018), asthma diagnosis (OR: 5.85, 95% CI: 4.83–7.08), poor economic status (OR = 4.95, 95% CI: 2.38 to 10.28, p<0.05), and smoke-related cooking process (OR = 3.97, 95% CI: 2.00-7.88, p<0.05). Conclusion: The most associated host risk factor was health-related conditions while the most associated environmental risk factor was the smoke-related environment. Daytime abnormal behavior, the risk factor with the highest odds ratio.
Latar Belakang: Pneumonia adalah penyebab kematian nomor satu pada anak usia di bawah 5 tahun di seluruh dunia, terutama di Asia, dalam bentuk community-acquired pneumonia. Pencegahan primer penyakit ini sangat penting; Oleh karena itu, perlu dilakukan analisis faktor risiko pneumonia pada anak usia di bawah 5 tahun. Metode: Berdasarkan pedoman PRISMA, tinjauan literatur untuk studi observasional dilakukan melalui database PubMed MEDLINE dengan kriteria inklusi dan eksklusi yang telah ditetapkan. Studi yang diperoleh dinilai menggunakan metode STROBE. Sebanyak 8 penelitian memenuhi kriteria dengan total subjek 16.862 anak. Hasil: Skor STROBE berkisar antara 12,2 hingga 19,6. Beberapa faktor risiko yang berhubungan dengan pneumonia; faktor risiko dengan odds ratio tertinggi adalah perilaku abnormal di siang hari (OR: 11,06; 95% CI: 1,51-81,26; p=0,018), asma (OR: 5,85; 95% CI: 4,83-7,08), status ekonomi buruk (OR=4,95; 95% CI: 2,38-10,28; p<0,05), dan proses memasak yang menghasilkan asap (OR=3,97; 95% CI: 2,00-7,88; p<0,05). Simpulan: Faktor risiko yang paling banyak dikaitkan adalah kondisi kesehatan subjek, sedangkan faktor risiko lingkungan yang paling banyak dibahas adalah lingkungan yang berhubungan dengan asap. Perilaku abnormal di siang hari yang merupakan faktor risiko dengan odds ratio tertinggi.
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References
Rudan I, Boschi-Pinto C, Biloglav Z, Mulholland K, Campbell H. Epidemiology and etiology of childhood pneumonia. Bull WHO. 2008;86(5):408–16.
Rudan I, O’Brien KL, Nair H, Liu L, Theodoratou E, Qazi S, et al. Epidemiology and etiology of childhood pneumonia in 2010: Estimates of incidence, severe morbidity, mortality, underlying risk factors and causative pathogens for 192 countries. J Glob Health. 2013;3(1):010401.
Steel HC, Cockeran R, Anderson R, Feldman C. Overview of community-acquired pneumonia and the role of inflammatory mechanisms in the immunopathogenesis of severe pneumococcal disease. Mediators Inflamm. 2013;2013:490346. doi: 10.1155/2013/490346.
Song JH, Huh K, Chung DR. Community-acquired pneumonia in the Asia-Pacific region. Semin Respir Crit Care Med. 2016;37(6):839–54.
Restrepo MI, Faverio P, Anzueto A. Long-term prognosis in community-acquired pneumonia. Curr Opin Infect Dis. 2013;26(2):151–8.
Johnstone J, Eurich DT, Majumdar SR, Jin Y, Marrie TJ. Long-term morbidity and mortality after hospitalization with community-acquired pneumonia: A population-based cohort study. Medicine (Baltimore) 2008;87(6):329–34.
Kumar R, Arora N, Santosham M. South Asia symposium on pneumococcal disease and the promise of vaccines – Meeting report. Vaccine 2016;34(23):2622–6.
DeAntonio R, Yarzabal JP, Cruz JP, Schmidt JE, Kleijnen J. Epidemiology of community-acquired pneumonia and implications for vaccination of children living in developing and newly industrialized countries: A systematic literature review. Hum Vaccines Immunother. 2016;12(9):2422–40.
Jackson S, Mathews KH, Pulanić D, Falconer R, Rudan I, Campbell H, et al. Risk factors for severe acute lower respiratory infections in children – a systematic review and meta-analysis. Croat Med J. 2013;54(2):110–21.
Sonego M, Pellegrin MC, Becker G, Lazzerini M. Risk factors for mortality from acute lower respiratory infections (ALRI) in children under five years of age in low and middle-income countries: A systematic review and meta-analysis of observational studies. PloS One. 2015;10(1):e0116380.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. Syst Rev. 2021;10:89.
Cuschieri S. The STROBE guidelines. Saudi J Anaesth. 2019;13(Suppl 1):S31–4.
Mahalanabis D, Gupta S, Paul D, Gupta A, Lahiri M, Khaled MA. Risk factors for pneumonia in infants and young children and the role of solid fuel for cooking: A case-control study. Epidemiol Infect. 2002;129(1):65–71.
Chang J, Liu W, Huang C. Residential ambient traffic in relation to childhood pneumonia among urban children in Shandong, China: A cross-sectional study. Int J Environ Res Public Health. 2018;15(6):1076.
Goldbart AD, Tal A, Givon-Lavi N, Bar-Ziv J, Dagan R, Greenberg D. Sleep-disordered breathing is a risk factor for community-acquired alveolar pneumonia in early childhood. Chest. 2012;141(5):1210–5.
Karki S, Fitzpatrick AL, Shrestha S. Risk factors for pneumonia in children under 5 years in a teaching hospital in Nepal. Kathmandu Univ Med J KUMJ. 2014;12(48):247–52.
Coles CL, Fraser D, Givon-Lavi N, Greenberg D, Gorodischer R, Bar-Ziv J, et al. Nutritional status and diarrheal illness as independent risk factors for alveolar pneumonia. Am J Epidemiol. 2005;162(10):999–1007.
Kosai H, Tamaki R, Saito M, Tohma K, Alday PP, Tan AG, et al. Incidence and risk factors of childhood pneumonia-like episodes in Biliran Island, Philippines--A community-based study. PloS One 2015;10(5):e0125009.
Yang HJ, Kim HJ, Yu J, Lee E, Jung YH, Kim HY, et al. Inhalation toxicity of humidifier disinfectants as a risk factor of children’s interstitial lung disease in Korea: A case-control study. PLoS ONE 2013;8(6):e64430.
Miao Y, Shen YM, Lu C, Zeng J, Deng Q. Maternal exposure to ambient air temperature during pregnancy and early childhood pneumonia. J Therm Biol. 2017;69:288–93.
Chiner E, Llombart M, Valls J, Pastor E, Sancho-Chust JN, Andreu AL, et al. Association between obstructive sleep apnea and community-acquired pneumonia. PLoS ONE 2016;11(4):e0152749.
Obert J, Burgel PR. Pneumococcal infections: Association with asthma and COPD. Med Mal Infect. 2012;42(5):188–92.
Qian CJ, Coulombe J, Suissa S, Ernst P. Pneumonia risk in asthma patients using inhaled corticosteroids: A quasi‐cohort study. Br J Clin Pharmacol. 2017;83(9):2077–86.
Iannella H, Luna C, Waterer G. Inhaled corticosteroids and the increased risk of pneumonia: What’s new? A 2015 updated review. Ther Adv Respir Dis. 2016;10(3):235–55.
Aghapour M, Ubags ND, Bruder D, Hiemstra PS, Sidhaye V, Rezaee F, et al. Role of air pollutants in airway epithelial barrier dysfunction in asthma and COPD. Eur Respir Rev. 2022;31(163):210112.
Beentjes D, Shears RK, French N, Neill DR, Kadioglu A. Mechanistic insights into the impact of air pollution on pneumococcal pathogenesis and transmission. Am J Respir Crit Care Med. 2022; 206(9):1070–80.
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